Disabling musculoskeletal pain and its relation to somatization: a community-based postal survey
Disabling musculoskeletal pain and its relation to somatization: a community-based postal survey
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DOI：
10.1093/occmed/kqi142
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发表时间：
2005-12-01
影响因子：
5.1
通讯作者：
Coggon, D
中科院分区：
文献类型：
--
作者：
Palmer, KT;Calnan, M;Coggon, D
背景躯体化(一种从躯体症状中报告痛苦的倾向)在肌肉骨骼疾病的职业研究中研究较少，但具有潜在的重要、混淆和影响修饰物的作用。目的评估躯体化作为致残局部疼痛的危险因素的作用。被问及在过去12个月中影响手臂、腰背、膝盖或这些部位的组合的慢性和致残性疼痛。使用简明症状问卷的要素评估身体症状带来的痛苦，并使用简明36(SF-36)评估心理健康。结果在2632名应答者中，24%的人报告了一个或多个部位的慢性疼痛，25%的人报告了致残性疼痛。根据报告的令人烦恼的躯体症状的数量，慢性或致残性疼痛的风险显著增加。例如，在过去7天内有2种躯体症状的患者中，慢性上肢疼痛的HR为3.9(95%可信区间2.9~5.3)，致残上肢疼痛的HR为5.8(95%可信区间4.1~8.3)。在腰部和膝盖也发现了类似的模式，根据致残性疼痛部位的数量，风险存在增加的梯度。结论躯体化倾向可作为肌肉骨骼疼痛职业性危险因素研究中的一个可能的混杂因素或效应修饰物。
Background Somatization (a tendency to report distress from somatic symptoms) is a little studied, but potentially important, confounder and effect modifier in occupational studies of musculoskeletal disease.Aims To assess the role of somatization as a risk factor for disabling regional pain.Methods A questionnaire was mailed to 4998 subjects of working age. Questions were asked about chronic and disabling pain in the past 12 months affecting the arm, low back, knee or combinations of these sites. Distress from physical symptoms was assessed using elements of the Brief Symptom Inventory and mental well-being was assessed using the short-form 36 (SF-36). Associations were examined by modified Cox regression and expressed as hazard ratios (HRs) with 95% confidence intervals (CI).Results Among 2632 responders, 24% reported chronic pain and 25% disabling pain at one or several sites. Risk of chronic or disabling pain increased strongly according to the number of somatic symptoms reported as bothersome. For example, the HR for chronic upper limb pain in those distressed by >= 2 somatic symptoms in the past 7 days versus none was 3.9 (95% CI 2.9-5.3), and that of disabling upper limb pain was 5.8 (95% CI 4.1-8.3). Similar patterns were found for the low back and knee, and there was a gradient of increasing risk according to the number of sites with disabling pain. In comparison, associations with SF-36 mental well-being score were weaker.Conclusion Somatizing tendency should be evaluated as a possible confounder or effect modifier in studies of occupational risk factors for musculoskeletal pain.